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This paper estimates the influence of inadequate access to healthcare services on the rate of Emergency Room (ER) hospital visits in Australia. We take micro-data on different types of healthcare shortfalls from the 2012 Australian Survey of Disability, Aging and Carers, and employ Propensity Score Matching (PSM) techniques to identify their effects on ER visits. We find that shortfalls in access to various medical services increases ER visits for individuals with mental and physical conditions by about the same degree. Conversely, inadequate community care services significantly predict ER visits for individuals with physical conditions, but not for persons with mental conditions. The lack of predictive power for inadequate community care for persons with mental health problems is surprising, as “acopia” is thought to be a significant driver of crises that require emergency treatment. We discuss some of the mechanisms that may underpin this finding and address the policy implications of our results. Lastly a number of robustness checks and diagnostics tests are presented which confirm that our modelling assumptions are not violated and that our results are insensitive to the choice of matching algorithms. [ABSTRACT FROM AUTHOR]

Literature has consistently cited early childhood interventions as an effective method for mitigating or preventing future delinquency in at-risk children. In this manuscript, we propose an adapted model of Intergenerational Care presenting as a possible intervention strategy for children at risk of delinquency. This model of care draws from programmes that provide formal care and support for older people and young children, with a primary focus on intergenerational interactions that focus on respite day care, community engagement, educational pedagogy across generations and evaluation. Using a specific model of Intergenerational Care, we incorporated three components of existing childhood intervention strategies: preparing for school readiness, promoting social skills with elders and peers, and managing behaviour. While no intervention strategy targeting children at risk of delinquency has made use of intergenerational interactions, the adapted Intergenerational Care model that we propose, with these three components supported by the existing literature, offers a unique and promising approach for preventing future delinquent behaviour in children. Recommendations for longitudinal research are also proposed. [ABSTRACT FROM AUTHOR]

Family plays a vital role in supporting individuals with dementia to reside in the community, thus delaying institutionalisation. Existing research indicates that the burden of care-giving is particularly high for those caring for a person with dementia. Yet, little is known about the uptake of community services by people with a diagnosis of dementia. Therefore, this study aims to better understand the relationship between cognitive impairment and the receipt of community care services. In order to examine the relationship, secondary data collected across Queensland, Australia, from 59,352 home-care clients aged 65 and over during 2007-2008 are analysed. This cross-sectional study uses regression analyses to estimate the relationship between cognitive impairment and service mix, while controlling for socio-demographic characteristics. The dependent variables include formal services, informal care and total home-care service hours during a 12-month period. The findings of this study demonstrate that cognitive impairment is associated with accessing more hours of respite and day centre care but fewer hours of other formal care services. Additionally, the likelihood of support from an informal caregiver increases when a client becomes cognitively impaired. Therefore, this study demonstrates that there is an increased need for respite programmes to support informal caregivers in the future, as the population of people living with dementia increases. These findings support the need for investigations of new and innovative respite models in the future. [ABSTRACT FROM AUTHOR]

Objectives. To identify characteristics associated with the likelihood of a client receiving a referral to the Home and Community Care (HACC) program from various sources. Methods. Data were collected from 73 809 home care clients during 2007-08. Binary logistic and multinomial logistic regression were used to investigate the likelihood of a client being referred by health workers v. non-health workers. Results. Females and clients cared for by their parents were less likely to receive referrals from health workers than non-health workers after confounding variables were controlled for. While poorer functional ability of clients increased the probability of receiving a referral from a health worker, the opposite was true for those with behavioural problems. Over 43% of the sample either self-referred or was referred by family or friends. Conclusions. Eligible individuals may miss out on services unless they or their family take the initiative to refer. There is a need for improved methods and incentives to support and encourage health workers to refer eligible individuals to the program. What is known about the topic? The absence or inappropriate referral to a suitable home care program can place pressure on formalised institutions and increase burdens on family members and the community. Factors largely unrelated to healthcare needs carry significant weight in determining hospital discharge decisions and home care referrals by practitioners. What does this paper add? The effectiveness of the HACC program is dependent on the referrer who acts to inform and facilitate individuals to the program. The purpose of this study is to identify the characteristics associated with the likelihood of individuals receiving a referral to the HACC program from various sources. What are the implications for practitioners? This study will assist policy makers and practitioners in developing effective strategies that transition individuals to suitable home care services in a timely manner. An effective referral process would provide opportunities for implementing preventative strategies that reduce disability rates among individuals and the burden of care for the community. For instance, individuals with unmet needs may be at higher risk from injury at home through inadequate monitoring of nutrient and medication intake and inappropriate home surroundings. Improving knowledge about care options and providing appropriate incentives that encourage health workers to refer individuals would be an effective start in improving the health outcomes of an ageing population. [ABSTRACT FROM AUTHOR]

Background: In Australia a persistent and sizable gender wage gap exists. In recent years this gap has been steadily widening. The negative impact of gender wage differentials is the disincentive to work more hours. This implies a substantial cost on the Australian health sector. This study aimed to identify the magnitude of gender wage differentials within the health sector. The investigation accounts for unpaid overtime. Given the limited availability of information, little empirical evidence exists that accounts for unpaid overtime.Methods: Information was collected from a sample of 10,066 Australian full-time employees within the health sector. Initially, ordinary least-squares regression was used to identify the gender wage gap when unpaid overtime was included and then excluded from the model. The sample was also stratified by gender and then by occupation to allow for comparisons. Later the Blinder-Oaxaca decomposition method was employed to identify and quantify the contribution of individual endowments to wage differentials between males and females.Results: The analyses of data revealed a gender wage gap that varied across occupations. The inclusion of unpaid overtime in the analysis led to a slight reduction in the wage differential. The results showed an adjusted wage gap of 16.7%.Conclusions: Unpaid overtime made a significant but small contribution to wage differentials. Being female remained the major contributing factor to the wage gap. Given that wage differentials provide a disincentive to work more hours, serious attempts to deal with the skilled labour shortage in the health sector need to address the gender wage gap. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a correlational study of the relationships between work-related injury-risk events and modifiable risk factors in a nursing population after controlling for socioeconomic factors. Background. Nurses are at high risk for work-related injury. Work-related injury is strongly influenced by psychosocial factors and physical job-related exposures, but the magnitude of effect from modifiable factors remains unclear. Method. Data were based on the Work Outcomes Research Cost-benefit survey conducted in Australia during 2005 and 2006. The study sample of 5724 represented ~14% of nurses in Queensland, Australia. Logistic regression was used to determine the magnitude of association of psychological distress (represented by the Kessler 6 score: six-item scale of psychological distress), the number of health conditions and various socioeconomic factors with work place injury. Results. High psychological distress was associated with a 5% probability of injury. As the number of health conditions increased, the probability of injury increased; 3 and ≥6 health conditions increased the chance of injury by 5% and 15% compared with no health conditions. Compared with the total sample, nurses who reported high levels of psychological distress demonstrated greater sensitivity to the number of health conditions. Computation of the marginal effects showed little difference in the likelihood of injury when the total sample was compared with nurses with <5 years of work experience. Conclusion. Effective occupational health and safety workplace programmes that target modifiable factors such as psychological distress and physical health conditions may improve the health capital of nurses and productivity levels within the profession. [ABSTRACT FROM AUTHOR]

Based on data collected from the Australian Survey of Disability, Ageing and Carer's in 2 003, this study investigated the factors that influenced the assistance received by primary care givers of non-institutionalized individuals aged 15 years and over with either profound or severe disabilities. An understanding of care givers and their use of support systems will assist policy makers in implementing strategies that ensure the viability of the community care programs by meeting the demands within the health sector as demographics change over time. This study found that the majority of primary care givers (61%) did not receive any main source of assistance. Results from the multinomial regression revealed that care givers less likely to receive any main source of assistance included those who were spouses of recipients, younger in age, did not participate in the labor force and resided in remote regions of Australia. Individuals caring for older aged recipients or recipients that possessed a severe rather than profound disability were also less likely to receive any main source of assistance. Care givers of recipients with either a physical or mental main disabling condition tended to seek informal and formal assistance, respectively. It is interesting to note that, after controlling for other variables, the gender of the care giver did not impact on the type of assistance received. [ABSTRACT FROM AUTHOR]

Intergenerational care is a program where both the younger and older generations are receiving programmed care in an environment where activities and resources are shared between them. Anecdotally, an intergenerational care program takes on many forms. This paper presents a systematic literature review of intergenerational care models. Our findings are relevant to policy makers as the paper highlights the opportunities to create an age-friendly environment by introducing intergenerational models in Australia, where intergenerational care development is in its infancy. Future research will help articulate the personal, social, and economic value of intergenerational care. [ABSTRACT FROM AUTHOR]

In this article the authors discuss several studies on older people's risk of malnutrition and falls in care homes. They examine the factors that affect the quality and kinds of services provided by care givers to their clients, and compares the services given by hospitals and care homes based on various researches. The authors also discuss their study which reveals that the disparities in health care provision is common with other previous studies.

Objective: The service type offered by a home care agency contracted by the Queensland government is not based on the qualifications of the worker providing the service, but the service itself. This allows agencies to substitute certain levels and categories of labour in order to provide a service to meet their contract obligations. This study investigated evidence of labour substitution between nursing and allied health services. Methods: Correlation and regression analysis was performed on the data collected from 218 clients of a branch of a community-based service agency operating nationally in Brisbane, Australia, during April, May and June 2005. Results: The results of the regression analysis revealed that when either allied health or nursing time rose by 10%, all else held constant, it was predicted that the other would fall by 4%. The subcategories, registered/enrolled nursing and physiotherapy, appeared to drive the inverse relationship between nursing and allied health service time. Registered/enrolled nursing service time was more sensitive to changes in physiotherapy rather than the other way around. Conclusions: The higher labour turnover among allied health staff compared with the nursing staff reported by the agency implies a substitution of labour between the two professions to ensure that the needs of clients are met. Health policy makers and health care professional educators need to acknowledge that workforce shortages will inevitably reshape professional boundaries. Leaving labour-force substitution undiscussed and unplanned may compromise the quality and safety of care. [ABSTRACT FROM AUTHOR]

Objective: To examine the use of respite services among carers of non-institutionalised individuals aged 15 and over with either profound or severe disabilities. Methods: Based on data collected from the Australian Survey of Disability, Ageing and Carers in 2003, the investigation evaluated the statistical significance of a number of carer and recipient characteristics on the likelihood of the use of respite services. Further analysis assisted in identifying the support most desired by the majority of carers (88.6%, n = 243 690) who have never used respite. Results: The results revealed that social and cultural factors played a critical role in the receipt of respite services. Family relationships were important. Just under one-fifth of all primary carers most preferred more financial assistance in their role as caregiver. After controlling for confounding variables it was found that, compared with other forms of assistance, the desire for an improvement in the primary carers' own health was more likely among non-respite users. This may reflect the carers' preference to improve their own capacity to service the recipient rather than rely on others outside the household. Conclusions: Since the recipients under investigation typically possess core communication restrictions and highly individualised needs, it is speculated that carers perceive family members as better able to interpret and meet the sporadic and individualised care demands of recipients. Implications: Given the low usage of respite services among primary informal carers, policy makers and health organisations need to dispel the "one size fits all" approach to support services for households. [ABSTRACT FROM AUTHOR]

Guidelines for implementing health promotion programmes within university settings outline key action areas for addressing health concerns. Further guidance is needed to help manage specific health promotion activities according to the needs and resources available to universities. Decisions about allocating resources to improve employee health depend on diverse factors such as the workplace, industry, country, and employee. A more nuanced understanding of health promotion programme implementation should help universities address the alarming rates of occupational stress reported among employees. This present study develops a taxonomy to help universities implement appropriate activities. Content analysis and interview findings highlight the importance of communication between workplaces and employees to determine the motivations for adopting health promotion activities. Collaboration between an extensive network of stakeholders will likely ensure that appropriate activities are available, supported, and implemented to target employee health concerns. [ABSTRACT FROM AUTHOR]

Objective: In Australia it has been estimated that mental health symptoms result in a loss of $ AU2.7 billion in employee productivity. To date, however, there has been only one study quantifying employee productivity decrements due to mental disorders when treatment-seeking behaviours are considered. The aim of the current paper was to estimate employee work productivity by mental health symptoms while considering different treatment-seeking behaviours. Method: A total of 60 556 full-time employees responded to the World Health Organization Health and Work Performance Questionnaire. This questionnaire is designed to monitor the work productivity of employees for chronic and acute physical and mental health conditions. Contained within the questionnaire is the Kessler 6, a scale measuring psychological distress along with an evaluation of employee treatment-seeking behaviours for depression, anxiety and any other emotional problems. A univariate analysis of variance was performed for employee productivity using the interaction between Kessler 6 severity categories and treatment-seeking behaviours. Results: A total of 9.6% of employees have moderate psychological distress and a further 4.5% have high psychological distress. Increasing psychological distress from low to moderate then to high levels is associated with increasing productivity decrements (6.4%, 9.4% and 20.9% decrements, respectively) for employees in current treatment. Combining the prevalence of Kessler 6 categories with treatment-seeking behaviours, mean 2009 salaries and number of Australian employees in 2009, it is estimated that psychological distress produces an $ AU5.9 billion reduction in Australian employee productivity per annum. Conclusions: The estimated loss of $ AU5.9 billion in employee productivity due to mental health problems is substantially higher than previous estimates. This finding is especially pertinent given the global economic crisis, when psychological distress among employees is likely to be increasing. Effective treatment for mental health problems yields substantial increases in employee productivity and would be a sound economic investment for employers. [ABSTRACT FROM AUTHOR]

Workplace health promotion programmes (WHPPs) are more likely to succeed where design and implementation account for the influence of health's complex, systemic nature. Thus, a greater understanding of how frameworks developed to progress WHPPs are operationalized across different countries and industries is needed. This study investigates health concerns targeted in an underexplored setting—Australian universities, describing how diverse programmes are implemented to target different health issues and health risk factors. Content analysis is used to outline how Australian universities implement WHPPs to target diverse health concerns. Content from 497 website documents is collected and analysed using NVivo software. A framework for examining diverse WHPPs currently used in practice is developed. Based on this framework, it was evident that Australian universities emphasized initiatives targeting health issues focusing on 'mental health' and 'diabetes'. Regarding health risk factors, 'alcohol and other addictions', 'discrimination and harassment', and 'physical activity' were emphasized. Links between different health concerns targeted and corresponding WHPPs implemented, provide workplaces with a benchmark for designing and implementing programmes. University WHPPs targeted a diverse range of health concerns when enough legal and political motivations to do so existed. These findings about the motivations for improving employee health indicate a potential gap between health promotion benefits reported in literature and the appreciation for these benefits in practice. [ABSTRACT FROM AUTHOR]

This paper presents a systematic literature review of the qualitative evidence in relation to intergenerational learning programs, principles, and practices. The aim of the review is to develop the evidence base to form an Intergenerational Model of Practice Framework based on the Early Years Learning Framework (EYLF). The EYLF comprises three inter-related elements: principles, practice, and outcomes. The results of this systematic literature review revealed commonalities across these elements and therefore what is needed to underpin the development of an evidence-based Intergenerational Model of Practice Framework. [ABSTRACT FROM PUBLISHER]

In the Australian context, the out-of-home care of children and respite service for older adults are segregated. Yet internationally there has been a shift toward intergenerational programs that purposefully bring together younger and older people for mutual benefits. This paper examines the enablers of, supports for, and constraints of introducing intergenerational care programs (IGC) within the Australian legislation and regulations of child-care and aged-care programs. In doing so, program design features, workforce strategies, and built environment are considered. The literature indicates that the meshing of standards into IGC programs provides an opportunity to make intergenerational care an attractive model for respite to caregivers and recipients of care, while providing intergenerational contact for younger families. Such a program is likely to be cost effective with economies-of-scale workforce efficiencies. Future research will involve a needs assessment of potential consumers to explore the possible demand for intergenerational care programs within Australia before conducting a trial of different intergenerational care programs. [ABSTRACT FROM PUBLISHER]

The article presents a study regarding the prevalence of beryllium sensitization of conventional munition workers at the U.S. Department of Defense. The participants of the research were screened using a Beryllium Lymphocyte Proliferation Test method. Findings reveal that 1.5% of the workers were sensitized to beryllium due to their occasional resurfacing on copper, which contains 2% beryllium. It adds that workers with low beryllium exposure also inhibits a low risk to beryllium sensitization.

Background: The health condition of workers is known to impact on productivity outcomes. The relationship between health and productivity is of increasing interest amid the need to increase productivity to meet global financial challenges. Prevalence of psychological distress is also of growing concern in Australia with a two-fold increase in the prevalence of psychological distress in Australia from 1997-2005. Methods: We used the cross-sectional data set from the Australian Work Outcomes Research Cost-benefit (WORC) study to explore the impacts of health conditions with and without co-morbid psychological distress, compared to those with neither condition, in a sample of approximately 78,000 working Australians. The World Health Organisation Health and Performance Questionnaire was used which provided data on demographic characteristics, health condition and working conditions. Data were analysed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism respectively. Results: For both absenteeism and presenteeism productivity measures there was a greater risk of productivity loss associated when health conditions were co-morbid with psychological distress. For some conditions this risk was much greater for those with co-morbid psychological distress compared to those without. Conclusions: Co-morbid psychological distress demonstrates an increased risk of productivity loss for a range of health conditions. These findings highlight the need for further research to determine whether co-morbid psychological distress potentially exacerbates lost productivity. [ABSTRACT FROM AUTHOR]

The article discusses a study that explores the work performance of employees with respect to Australian working conditions, particularly the demand to work for longer hours. The study found that the health-related absenteeism and work performance losses contributed to increased hours of work, low annual wage, and job insecurity. It was noted that the Australian working conditions contributed to low work performance and high absenteeism of employees regardless of their health status.

The article presents a cross-sectional study conducted to investigate the correlations between employee work productivity, psychological distress and the treatment of mental disorders in Australia. The study involves employees who completed the Health and Work Performance Questionnaire (HPQ). It shows that the productivity of employees who do not have psychological distress and have not been in treated for mental disorders is 20 percent while those treated for a mental disorder is 17 percent.

Background: The health condition of workers is known to impact on productivity outcomes. The relationship between health and productivity is of increasing interest amid the need to increase productivity to meet global financial challenges. Prevalence of psychological distress is also of growing concern in Australia with a two-fold increase in the prevalence of psychological distress in Australia from 1997-2005.Methods: We used the cross-sectional data set from the Australian Work Outcomes Research Cost-benefit (WORC) study to explore the impacts of health conditions with and without co-morbid psychological distress, compared to those with neither condition, in a sample of approximately 78,000 working Australians. The World Health Organisation Health and Performance Questionnaire was used which provided data on demographic characteristics, health condition and working conditions. Data were analysed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism respectively.Results: For both absenteeism and presenteeism productivity measures there was a greater risk of productivity loss associated when health conditions were co-morbid with psychological distress. For some conditions this risk was much greater for those with co-morbid psychological distress compared to those without.Conclusions: Co-morbid psychological distress demonstrates an increased risk of productivity loss for a range of health conditions. These findings highlight the need for further research to determine whether co-morbid psychological distress potentially exacerbates lost productivity. [ABSTRACT FROM AUTHOR]